Motivational processes contributing to disturbances in women's body image and eating.

Reinforcement Sensitivity Theory (RST) provides a neurobiological personality framework for understanding approach and avoidance behavioural patterns. Recent research suggests an association between RST personality traits (reward interest and behavioural inhibition system [BIS]) and women's body image and eating behaviours. The current study aimed to extend this research by testing for indirect relationships between reward interest and BIS and eating disorder symptoms, as mediated through thin ideal internalisation. Adult female participants (N = 354, M = 22.06 years of age, SD = 6.78) completed self-report measures of reward interest, BIS, thin ideal internalisation, and eating disorder symptoms (i.e., restraint, eating concerns, weight and shape concerns). Indirect relationships were tested using bootstrapped mediation analyses. Results showed thin ideal internalisation mediated the pathways between the BIS and restraint, eating concern, and weight and shape concerns. Reward interest was not associated with thin ideal internalisation, or with eating disorder symptoms. Although the application of RST to women's body image is an emerging research area, these novel findings suggest BIS trait sensitivity may increase women's risk of body image concerns and restricted eating, via increased levels of thin ideal internalisation. Overall, these findings provide preliminary support for inclusion of individual differences in BIS sensitivity in risk factor models of body image and eating disturbances. Future research should aim to replicate these findings in more diverse samples, using longitudinal designs.

Thin Ideal Internalization Assessment (THIINA): Development and Psychometric Validation of a New Measure of Female Body Image.

Thin ideal internalization is widely implicated in women's body image and eating disturbances. A recently proposed multidimensional operationalization of internalization suggests the brevity and construct validity of existing questionnaires may limit the assessment of thin ideal internalization. Therefore, this research aimed to develop a new questionnaire (i.e., Thin Ideal Internalization Assessment; THIINA) to comprehensively assess thin ideal internalization. In Study 1, 301 female participants were administered the THIINA. Exploratory factor analyses revealed the 17-item THIINA had a stable 3-factor structure reflecting thin idealization, thin overvaluation, and thin behavioral drive. In Study 2, 337 female participants were administered the THIINA and validation measures. Confirmatory factor analysis confirmed stability of the 3-factor structure and findings supported convergent, discriminant, and incremental validity of the THIINA. Support for temporal stability was found within a sub-sample of participants (n = 132). The THIINA demonstrated strong psychometric properties, a stable three-factor structure representing theoretically-driven domains, and support for the creation of a composite score representing overall thin ideal internalization. These findings suggest the multidimensional operationalization and measurement of thin ideal internalization could improve theoretical and clinical understanding of the impact of thin ideal internalization on women's body image and eating.

Reciprocal relations between past behavior, implicit beliefs, and habits: A cross-lagged panel design.

The current study assessed cross-lagged relationships between binge drinking, implicit beliefs, and habit in undergraduate university students (N = 105). Students completed self-report survey and implicit measures in lab visits 3 months apart. A structural equation model revealed cross-lagged relations between habit and behavior, and some evidence for a reciprocal relationship between implicit beliefs and habit. Implicit beliefs were related to alcohol behavior across time, but no cross-lagged relationship was observed. Findings provide preliminary support for recent advances in habit theory, suggesting that implicit beliefs and habit may develop in tandem or even share common knowledge structures and schemas.

Unravelling reciprocal effects among young adults' binge drinking, stress, and anticipated regret.

Problematic alcohol consumption represents a critical risk to young adults' mental and physical health (WHO, 2018). As a result, understanding negative consequences that stem from young adults' binge drinking and inter-related factors that may mitigate increases in binge drinking has much to offer scholars and practitioners. In the current study, a two-wave random intercept cross-lagged panel design was used to examine the reciprocal inter-relations among stress, anticipated regret, and binge drinking within a lab-based study of young adults (N = 109, Mage = 19.85). Within-person findings indicated that high life stress and low anticipated regret predicted subsequent increases in binge drinking three months later, accounting for between-person stability in these constructs. All told, findings point to life stress as a robust predictor of increased binge drinking, and anticipated regret as a protective factor associated with reductions in binge drinking among young adults. Given that anticipated regret signalled subsequent drinking reductions, future research should consider ways to foreground anticipation of regret as a protective factor mitigating binge drinking increases.

Symptoms of Addictive Eating: What Do Different Health Professions Think?

The symptoms of addictive eating are often debated, with some overlap in symptoms with substance addictions or other disorders such as binge eating disorder. This study explored the levels of agreement with symptoms of addictive eating among different health professions, the conditions they provide advice for, and the population group/s they work with. An online cross-sectional survey was conducted in February-April 2020 including 142 health professionals (87% female, 65% residing in Australia, 28% each working in private practice/hospital settings). Of these, 47% were dietitians, 20% psychologists/psychotherapists/counsellors, 16% other health practitioners (e.g., social workers), 13% health researchers, and 5% medical professionals. Agreement with 11 statements relating to addictive eating symptoms was assessed on a scale of 1/strongly disagree to 5/strongly agree (e.g., certain foods produce physiological effects in the brain rewards system). Differences in agreement by health profession were assessed by one-way analysis of variance. There were significant differences in agreement with individual statements between health professions. Psychologists, psychotherapists, and counsellors reported lower agreement to statements relating to physiological effects in the reward system, withdrawal symptoms, and over-eating to alleviate stress/anxiety, than other professions (p < 0.05). Those providing advice for disordered eating only reported lower agreement across statements compared with those providing advice for overweight/obesity or both (p < 0.001). There were minimal differences based on the population group/s that health professionals work with. There is some agreement among health professionals regarding addictive eating symptoms, however, this differs by profession and the conditions they treat. This study provides a novel perspective on health professionals' views on addictive eating symptoms, and there is a need for more research to explore the concepts further.

From BIS to binge: The role of negative affect in the pathway between personality and binge eating.

Recent research has highlighted the utility of using revised Reinforcement Sensitivity Theory (RST) to further understand the individual differences that influence binge eating behaviours. The current study draws on both RST and theoretical models that implicate negative affect in binge eating, with the aim of identifying indirect pathways between individual differences in RST systems and binge eating as mediated through negative affect. Undergraduate students (n = 229, M = 22.67 years of age, SD = 8.95, 76% female) completed self-report measures of revised reinforcement sensitivities, negative affect and binge eating symptoms. Bootstrapped tests of indirect effects showed that negative affect mediated the pathway between the Behavioural Inhibition System (BIS) and binge eating symptoms. Additionally, negative affect mediated the pathway between rash impulsivity and binge eating symptoms. This study supports and extends previous research by highlighting the experience of negative affect as a possible mechanism through which heightened BIS and rash impulsivity leads to binge eating.

A narrative review of reward sensitivity, rash impulsivity, and food addiction in adolescents.

Adolescence represents a neurodevelopmental period characterised by heightened reward drive and weaker inhibitory control that may increase vulnerability to compulsive overconsumption of highly-palatable foods and food addiction. This narrative review aimed to summarise research investigating the presence of food addiction in adolescents and establish the role that impulsivity traits (i.e., reward sensitivity and rash impulsivity), previously linked to substance and behavioural addictions, play in contributing to food addiction in this cohort. It was found that the prevalence of food addiction was typically higher in studies that recruited adolescents who were overweight/obese or from clinical populations. Overall, impulsivity was found to be more consistently associated with food addiction, while the relationships between measures of reward sensitivity and food addiction were mixed. Findings of this review suggest trait impulsivity may contribute to food addiction in adolescents, however, further longitudinal and prospective research is recommended to confirm these findings and to investigate the potential interactive effects of reward sensitivity and rash impulsivity.

Strong is the New Skinny, but is it Ideal?: A Test of the Tripartite Influence Model using a new Measure of Fit-Ideal Internalisation.

Although the thin body ideal has been the epitome of western female beauty for decades, the more recent fit body ideal is becoming arguably more popular. This study aimed to test two versions of the tripartite influence model (TIM; Thompson, Heinberg, Altabe, & Tantleff-Dunn, 1999): one that included thin-ideal internalisation, and one that included fit-ideal internalisation, using path analysis. Participants were 558 Australian women aged 16-50 years (M = 22.06, SD = 7.41). All of the hypothesised paths were significant for both the thin- and fit-ideal internalisation models. The final models for both thin- and fit-ideal internalisation included extra, non-hypothesised paths from media to body dissatisfaction, and from social comparison to dieting, bulimic symptoms, and compulsive exercise. The two models differed in that the final model for thin-ideal internalisation included direct paths from thin-ideal internalisation to dieting and bulimic symptoms. The final model for fit-ideal internalisation, however, included a direct path from fit-ideal internalisation to compulsive exercise. It was concluded that, in contrast to the widely held perception that the fit ideal is a 'healthier' alternative to the thin ideal, fit ideal internalisation may be detrimental to female body satisfaction, disordered eating, and compulsive exercise.

Health Professionals' and Health Professional Trainees' Views on Addictive Eating Behaviours: A Cross-Sectional Survey.

Despite increasing research on the concept of addictive eating, there is currently no published evidence on the views of health professionals who potentially consult with patients presenting with addictive eating behaviours, or of students training to become health professionals. This study aimed to explore the views and understanding of addictive eating behaviours among health professionals and health professionals in training and to identify potential gaps in professional development training. An international online cross-sectional survey was conducted in February-April 2020. The survey (70 questions, 6 key areas) assessed participants' opinions and clinical experience of addictive eating; opinions on control, responsibility, and stigma relating to addictive eating; and knowledge of addictive eating and opinions on professional development training. In total, 142 health professionals and 33 health professionals in training completed the survey (mean age 38.1 ± 12.5 years, 65% from Australia/16% from the U.K.) Of the health professionals, 47% were dietitians and 16% were psychologists. Most participants (n = 126, 72%) reported that they have been asked by individuals about addictive eating. Half of the participants reported that they consider the term food addiction to be stigmatising for individuals (n = 88). Sixty percent (n = 105) reported that they were interested/very interested in receiving addictive eating training, with the top two preferred formats being online and self-paced, and face-to-face. These results demonstrate that addictive eating is supported by health professionals as they consult with patients presenting with this behaviour, which supports the views of the general community and demonstrates a need for health professional training.

Investigating the relationship between reward sensitivity, impulsivity, and food addiction: A systematic review.

OBJECTIVE: The aim of the current research was to identify the extent to which reward sensitivity and impulsivity were related to food addiction. METHOD: Forty-five studies, published from 2009 to June 2019, investigating reward sensitivity and/or impulsivity with food addiction as measured by the Yale Food Addiction Scale were reviewed. RESULTS: Reward sensitivity, as measured by the Sensitivity to Reward (SR) scale, was positively associated with food addiction in two studies, but failed to yield consistent results in other studies when measured with the Behavioral Inhibition/Behavioral Activation Scales. Self-report impulsivity, as measured by the Barratt Impulsiveness Scale (BIS-11), was consistently associated with food addiction, with attentional impulsivity and motor impulsivity the most consistent subscales. Similarly, food addiction was also consistently associated with Negative Urgency, Positive Urgency, and Lack of Perseverance as measured by the UPPS-P Impulsive Behavior Scale. Food addiction was inconsistently associated with disinhibition, as measured by behavioral tasks, indicating food addiction appears more aligned with self-report measures of impulsivity. CONCLUSIONS: Research in this field is dominated by university student, overweight and obese samples. Additional research is required to further tease out these relationships.

Testing a model of reward sensitivity, implicit and explicit drinker identity and hazardous drinking.

Objective: The aim of this study was to investigate both implicit and explicit drinker identity as mediators of reward sensitivity and problematic drinking. University students engage in problematic levels of alcohol consumption, exposing them to increased negative health outcomes. Although personality traits (e.g. reward sensitivity) and social-cognitive variables (e.g. implicit and explicit drinker identity) have been used to investigate drinking behaviour, few studies link personality and multiple indices of drinker identity to problematic drinking. Design: University students (N = 136) completed a drinker identity implicit association test, and questionnaires measuring reward sensitivity, explicit binge drinker identity and problematic drinking as part of a lab-based correlational study. Main Outcome Measures: The Alcohol Use Disorders Identification Test was the main outcome measure with participants self-reporting drinking frequency, quantity and negative physical and psychological outcomes of drinking over the past 3-months. Results: A mediation model revealed that reward sensitivity was significantly associated with explicit, but not implicit, binge drinker identity. Explicit binge drinker identity mediated the reward sensitivity and problematic drinking association. Conclusion: This research provides an evidence base for identity-based drinking interventions for students characterised by high reward sensitivity, by promoting identities that do not idealise problematic drinking behaviour.

An Investigation of the Impact of Childhood Trauma on Quality of Caregiving in High Risk Mothers: Does Maternal Substance Misuse Confer Additional Risk?

The quality of caregiving is often compromised when mothers have co-occurring difficulties such as substance misuse and problems associated with extreme emotional dysregulation. These, in turn, are associated with poor child outcomes. The aim of the current study was twofold. First, to investigate the potential differences in risk factors associated with poor child outcome by comparing three groups: substance misusing mothers (Substance Misusing Mothers; SMM); mothers matched on demographic characteristics (Matched Comparison Mothers; MCM) and mothers recruited from the community (Matched Control Comparison; MCC). Second, to investigate the underlying mechanisms which are associated with poor child outcome by testing a mediated moderation model to ascertain (i) whether environmental risk and borderline psychopathology was a mediator between maternal childhood trauma and quality of caregiving and (ii) maternal substance misuse status moderated outcome. There were no significant differences found between the SMM and MCM groups on the key variables, but significant differences on all variables for both SMM and MCM compared to CCM. The moderated mediation analysis found that while there was significant mediation of environmental risk and borderline pathology between maternal childhood trauma and child outcome, this was not moderated by maternal substance abuse status. The importance of environmental-risk as a mechanism leading to reduced caregiving quality suggest treatment programs need to consider targeting these factors in high risk families.

Similarities and differences in revised reinforcement sensitivities across eating disorder subtypes.

Reinforcement Sensitivity Theory has been used to investigate personality in the development and maintenance of disordered eating. However, the vast majority of research from this perspective has been limited by the use of measures developed to assess the original theory, rather than the significantly revised theory, potentially overlooking key personality differences in eating disorder subtypes. The current study aimed to overcome limitations when using measures based on the original theory by investigating differences and similarities in reinforcement sensitivity across eating disorder subtypes and healthy controls. The measure based on the revised theory assesses i) reward sensitivity [goal-drive persistence; reward interest, reward reactivity], ii) impulsivity, iii) behavioural inhibition, and iv) threat sensitivity. A total of 374 women from the community participated, including those with a past or present AN-R diagnosis (AN-R = 109); those with a past or present binge-type ED (Binge-type = 132); and healthy controls (HC = 133). Participants completed a questionnaire assessing personality, eating disorder symptoms, and past or present eating disorder diagnoses. Results showed that both the AN-R and Binge-type groups were higher in behavioural inhibition and threat sensitivity compared to the HC group. The Binge-type group showed higher impulsivity relative to the AN-R and HC group, and lower Goal-Drive Persistence relative to the HC group. The AN-R group showed lower Reward Interest and Reward Responsiveness relative to the HC group. This study supports and extends previous research with the findings of heightened threat and anxiety sensitivity in those with diagnosed eating disorders. Additionally, among those with a past or present eating disorder, the findings implicate impulsivity in differentiating bingeing versus restricting subtypes.

Is thin in everywhere?: A cross-cultural comparison of a subsection of Tripartite Influence Model in Australia and Malaysia.

Despite growing research investigating prevalence rates of BD among Malaysian women, there has been limited research conducted in Malaysia with respect to factors contributing to its development and consequences. This study tested a subsection of the Tripartite Influence Model, investigating whether sociocultural influences (family, peers, media) lead to thin ideal internalization, which in turn lead to body dissatisfaction (BD) and subsequently restrained eating and bulimic behaviours in both Australian and Malaysian women. Participants were 421 Australian and 399 Malaysian female emerging adults aged between 18 and 25 years, (M = 20.76; SD = 2.86) who completed questionnaires assessing sociocultural influences, thin ideal internalization, body dissatisfaction, restrained eating and bulimic behaviours. The model, largely supported in both cultures, had two points of difference. For Malaysian but not Australian women, family influence was significantly linked with internalization of the thin ideal. Although BD was significantly linked with restrained eating as predicted for Australian women (albeit rather weakly), it was not significantly linked with restrained eating for Malaysian women. The striking similarity of results across both cultures, suggests that Western body ideals, with their corresponding negative sequelae, have infiltrated the collectivist and developing nation of Malaysia.

Compulsive "grazing" and addictive tendencies towards food.

Evidence suggests that palatable foods can promote an addictive process akin to drugs of abuse. To date, research in the field of food addiction has focused largely on binge eating as a symptom of this condition. The present study investigated relationships between food addiction and other patterns of overeating, such as compulsive grazing-a behaviour with high relevance to bariatric surgery outcomes. Adults between the ages of 20 and 50 years (n = 232) were recruited for the study. Participants completed questionnaires to assess various eating behaviours and related personality measures. Regression analysis employed the Yale Food Addiction Scale (YFAS) as the dependent variable. Results indicated that addictive personality traits, reward-driven eating, and compulsive grazing each contributed unique variance to the YFAS symptom score. These findings provide novel insight into the association between a grazing pattern of overeating and food addiction, and emphasize that similar to traditional addiction disorders such as alcoholism, binge consumption is not the only pattern of compulsive intake.

Junk food advertising moderates the indirect effect of reward sensitivity and food consumption via the urge to eat.

The current study aimed to identify how underlying individual differences increases vulnerability to television food advertising. In particular, this study examined how reward sensitivity, a biologically-based predisposition to approach rewards (such as appetitive foods) in the environment, influenced participants' vulnerability to television food advertising and subsequent food consumption. Ninety-eight participants were randomly assigned to a cue condition (food cues versus non-food cues) and then viewed a 30 min documentary interrupted by advertising featuring a mix of food and neutral advertising (food cue condition) or only neutral advertising (non-food cue condition). Participants' reward sensitivity, approach motivation measured as urge to eat, and food consumption were recorded. Moderated mediation regression analyses revealed the positive association between reward sensitivity and food consumption was mediated by an increase in urge to eat, but only when participants were exposed to food advertising. These findings suggest heightened reward sensitivity, exposure to appetitive food cues, and approach motivation are key interacting mechanisms that may lead to maladaptive eating behaviours.

A laboratory model of impulsivity and alcohol use in late adolescence.

Impulsivity is a core characteristic of externalizing problems and a robust predictor of alcohol use in adolescence. There is little evidence on the causal mechanisms through which impulsivity influences drinking or how they are affected by key social factors (peer influence). This study reports the development of the first comprehensive laboratory model of adolescent impulsivity and alcohol use. One-hundred and twenty adolescents (50% female) of legal drinking age (M = 19.47 years, SD = 1.12) in Australia (18+ years) were subjected to 1 of 3 experimental manipulations to increase impulsive behavior (reward cue exposure, negative mood induction, ego depletion). Changes in disinhibition (stop-signal task) and reward-seeking (BAS-Fun Seeking) were measured before completing a laboratory drinking task alone or with a heavy-drinking confederate. Reward cue exposure increased alcohol consumption, with the effect mediated by increased reward-seeking. Negative mood induction increased disinhibition, but not drinking. The presence of a heavy-drinking peer directly increased alcohol consumption in an additive fashion. Findings provide causal evidence that extends survey-based research by highlighting the role of reward-related impulsivity in adolescent alcohol use. The new laboratory model can provide novel insights into the psychological processes underlying adolescent impulsivity and impulsivity-related drinking.

Exposure to food cues moderates the indirect effect of reward sensitivity and external eating via implicit eating expectancies.

Previous research has suggested that the expectancy "eating is rewarding" is one pathway driving the relationship between trait reward sensitivity and externally-driven eating. The aim of the current study was to extend previous research by examining the conditions under which the indirect effect of reward sensitivity and external eating via this eating expectancy occurs. Using a conditional indirect effects approach we tested the moderating effect of exposure to food cues (e.g., images) relative to non-food cues on the association between reward sensitivity and external eating, via eating expectancies. Participants (N = 119, M = 18.67 years of age, SD = 2.40) were university women who completed a computerised food expectancies task (E-TASK) in which they were randomly assigned to either an appetitive food cue condition or non-food cue condition and then responded to a series of eating expectancy statements or self-description personality statements. Participants also completed self-report trait measures of reward sensitivity in addition to measures of eating expectancies (i.e., endorsement of the belief that eating is a rewarding experience). Results revealed higher reward sensitivity was associated with faster reaction times to the eating expectancies statement. This was moderated by cue-condition such that the association between reward sensitivity and faster reaction time was only found in the food cue condition. Faster endorsement of this belief (i.e., reaction time) was also associated with greater external eating. These results provide additional support for the proposal that individuals high in reward sensitivity form implicit associations with positive beliefs about eating when exposed to food cues.

Reward sensitivity and food addiction in women.

Sensitivity to the rewarding properties of appetitive substances has long been implicated in excessive consumption of palatable foods and drugs of abuse. Previous research focusing on individual differences in reward responsiveness has found heightened trait reward sensitivity to be associated with binge-eating, hazardous drinking, and illicit substance use. Food addiction has been proposed as an extreme form of compulsive-overeating and has been associated with genetic markers of heightened reward responsiveness. However, little research has explicitly examined the association between reward sensitivity and food addiction. Further, the processes by which individual differences in this trait are associated with excessive over-consumption has not been determined. A total of 374 women from the community completed an online questionnaire assessing reward sensitivity, food addiction, emotional, externally-driven, and hedonic eating. High reward sensitivity was significantly associated with greater food addiction symptoms (r = 0.31). Bootstrapped tests of indirect effects found the relationship between reward sensitivity and food addiction symptom count to be uniquely mediated by binge-eating, emotional eating, and hedonic eating (notably, food availability). These indirect effects held even when controlling for BMI, anxiety, depression, and trait impulsivity. This study further supports the argument that high levels of reward sensitivity may offer a trait marker of vulnerability to excessive over-eating, beyond negative affect and impulse-control deficits. That the hedonic properties of food (especially food availability), emotional, and binge-eating behavior act as unique mediators suggest that interventions for reward-sensitive women presenting with food addiction may benefit from targeting food availability in addition to management of negative affect.

Differential Effects of Reward Drive and Rash Impulsivity on the Consumption of a Range of Hedonic Stimuli.

Background and aims Impulsivity has consistently been associated with over-consumption and addiction. Recent research has reconceptualized impulsivity as a two-dimensional construct ( Dawe, Gullo, & Loxton, 2004 ). This study explores the relationship of the two components of impulsivity, reward drive (RD) and rash impulsivity (RI), on a broad group of 23 hedonic consumption behaviors (e.g., gambling, substance use, eating, and media use). We tentatively grouped the behaviors into three descriptive classes: entertainment, foodstuffs, and illicit activities and substances. Results RD and RI positively predicted elevated levels of consumption in a community sample (N=5,391; 51% female), for the vast majority of the behaviors considered. However, the effect sizes for RD and RI varied significantly depending on the behavior; a pattern that appeared to be at least partially attributable to the class of consumption. Results support the view that RD is related more strongly to the consumption of products that provide social engagement or a sense of increased status; whereas RI better reflects an approach toward illicit or restricted products that are intensely rewarding with clear negative consequences. Discussion and conclusion Results support the utility of the two-factor model of impulsivity in explaining individual differences in patterns of hedonic consumption in the general population. We discuss findings in terms of strengthening current conceptualizations of RI and RD as having distinct implications with respect to health-related behaviors.